Alcohol, diabetes may mix – but only with caution
Parkland specialist says get informed, be prepared before sipping
A frosty beer or icy margarita can relax and refresh, but happy-hour beverages can be risky for someone with diabetes. April is Alcohol Awareness Month, a good time for everyone to review their relationship with alcohol, but particularly for those with health conditions like diabetes.
According to Luigi Meneghini, MD, MBA, Executive Director of the Global Diabetes Program at Parkland Health & Hospital System and Professor, Division of Endocrinology, The University of Texas Southwestern Medical Center, many people with diabetes can drink alcohol in moderation.
“But the word ‘moderation’ is very important,” Dr. Meneghini stressed. “Alcohol affects blood sugar differently depending on whether the person has had anything to eat and how much and how often the person drinks. The best thing to do is to check in with your doctor before drinking to be sure you can do so safely.”
An occasional drink when taken with food has little effect on blood sugar, but drinking without having eaten or when taking diabetes medications can cause your blood glucose to plummet to dangerously low levels. “You should never drink alcohol on an empty stomach,” Dr. Meneghini said.
Drinking habitually (three to four drinks daily) is unhealthy and can affect diabetes, blood pressure, and increase the risk of liver disease, heart disease and cancer. “This is unsafe for anyone, but particularly a person with diabetes. A person who is drinking this much should seek medical help to find ways to cut back or curtail their alcohol use,” Dr. Meneghini advised.
People with diabetes should follow the same guidelines as those without diabetes if they choose to drink. Women should have no more than one drink per day. Men should have no more than two drinks per day. (One drink is equal to a 12-ounce beer, 5 ounce glass of wine or 1-½ ounces of distilled spirits such as vodka, whiskey or gin.)
What are the risks of drinking for people with diabetes? According to Dr. Meneghini, they include:
- Hypoglycemia (low blood glucose reaction) first and foremost, from alcohol both reducing blood glucose levels and impairing the ability to recognize hypoglycemia
- Hyperglycemia (high blood glucose levels) when drinking beer or sweet wine, or due to increased appetite and eating stimulated by alcohol
- Increase in blood pressure, triglyceride (fat) levels in the bloodstream, excess calories (alcohol has more calories than carbohydrates or protein)
- Impaired ability to make appropriate decisions when using insulin to control diabetes
- Peripheral neuropathy and nerve damage are more common in people who drink more than the recommended daily amount
- Medication interactions are a risk for anyone drinking. Consult with your doctor about all of your medications before consuming alcohol.
If you want to sip safely, moderation and caution are key for anyone with diabetes. If your physician gives you the green light, keep these tips in mind:
- Don’t drink on an empty stomach or when your blood glucose is low.
- If you use carbohydrate counting to plan meals, don’t count alcohol in your plan as a carbohydrate choice.
- Dilute your alcohol intake by choosing light beer or wine spritzer made with ice and club soda.
- Avoid high-calorie alcoholic beverages like heavy craft beers or sugar-loaded mixed drinks.
- Carry or wear an I.D. that states that you have diabetes in the event of emergency. The symptoms of hypoglycemia and drunkenness are similar – dizziness, drowsiness and disorientation. Wearing an identification that says “I have diabetes” can alert others that you may need emergency medical assistance due to hypoglycemia.
- Don’t drink and drive.
- Check your blood glucose before drinking, while you drink and for 24 hours after consuming alcohol. If your blood glucose is low, eat something to raise it.
“The best beverage choices to hydrate oneself, whether you have diabetes or not, are the non-alcoholic variety,” Dr. Meneghini concluded, such as water, unsweetened tea or the occasional diet soda. “However, if you do want to enjoy a glass of wine, make sure to be prepared and enjoy the experience, rather than have to face the consequences.”
For more information about healthy food and drink choices, visit www.diabetes.org.
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